NPIMap

Organization Active NPI

Mott Women Healthcare PLLC

  • Specialist
  • New York, NY
National Provider Identifier
1881653509
Registry record updated Aug 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
197880 Issued in NY
Legal business name
MOTT WOMEN HEALTHCARE PLLC
Practice address
128 Mott St Ste 501
128 Mott Street, Suite 501
New York, NY 10013-5575
Phone
(212) 587-8838
Fax
(212) 587-0050
NPI assigned
Mar 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Edward V Chan, M.D.NPI 1952503476
Title
Doctor
Phone
(212) 587-8838

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 197880 NY Primary

Addresses

Primary practice location

128 Mott St Ste 501
128 Mott Street, Suite 501
New York, NY 10013-5575

Mailing address

128 Mott St Ste 501
128 Mott Street, Suite 501
New York, NY 10013-5575
Phone (212) 587-8838

Other identifiers 1

IdentifierTypeStateIssuer
01567573MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071019000395 NY Part B Supplier - Clinic/Group Practice 4688561269 Receives reassigned benefits from 2 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

128 Mott St
Ste 501
New York, NY 10013
Phone (212) 227-8588

41 Mott St
Fl 2
New York, NY 10013
Phone (212) 267-2719

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343779200000",
    "number": "1881653509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 MOTT ST STE 501",
            "address_2": "128 MOTT STREET, SUITE 501",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100135575",
            "telephone_number": "212-587-8838",
            "fax_number": "212-587-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 MOTT ST STE 501",
            "address_2": "128 MOTT STREET, SUITE 501",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100135575",
            "telephone_number": "212-587-8838",
            "fax_number": "212-587-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOTT WOMEN HEALTHCARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2012-08-01",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "212-587-8838",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "197880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01567573",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.